Related Experiment Videos
Anticoagulant effect of iohexol vs. ioxaglate during cardiac catheterization
J L Vacek1, K Hibiya, T L Rosamond
1Mid America Heart Institute, St. Luke's Hospital, Kansas City, Missouri.
Insights
Contrast agents iohexol and ioxaglate affect blood clotting differently during cardiac procedures. Ioxaglate does not show a significant anticoagulant advantage over iohexol, with both agents impacting clotting times.
Area of Science:
- Cardiovascular Medicine
- Radiology
- Pharmacology
Background:
- Contrast agent safety is crucial in cardiac catheterization (CC) and percutaneous transluminal coronary angioplasty (PTCA).
- Potential anticoagulant or procoagulant effects of contrast media may influence patient outcomes.
Purpose of the Study:
- To investigate the in vivo anticoagulant and procoagulant effects of iodinated contrast agents iohexol and ioxaglate.
- To compare the impact of iohexol versus ioxaglate on activated clotting time (ACT) and partial thromboplastin time (PTT) in patients undergoing CC/PTCA.
Main Methods:
- A study involving 177 patients undergoing CC or PTCA, administered either iohexol (N=111) or ioxaglate (N=66).
- Patients received varying doses of heparin (0, 2000 IU for CC; 10,000 IU for PTCA).
- ACT and PTT were measured to assess anticoagulant effects.
Main Results:
- Both ACT and PTT significantly increased with 10,000 IU heparin, with larger increases observed with iohexol.
- With 2000 IU heparin, significant ACT and PTT increases occurred only with iohexol.
- In the absence of heparin, both iohexol and ioxaglate caused significant decreases in ACT and PTT.
Conclusions:
- Iohexol demonstrates greater prolongation of ACT and PTT in the presence of heparin compared to ioxaglate.
- Neither iohexol nor ioxaglate exhibits a significant anticoagulant advantage over the other when no heparin is administered.
- These findings suggest that ioxaglate does not offer a superior anticoagulant profile compared to iohexol.
Abstract:
Contrast agent safety during cardiac catheterization (CC) may relate in part to anti- or procoagulant effect. We studied these effects in 177 patients who underwent standard CC (N=112) or percutaneous transluminal coronary angioplasty (PTCA) (N=65) and received either iohexol (N=111) or ioxaglate (N=66). Patients received either 0 or 2000u heparin for CC or 10,000u for PTCA. The groups were similar in regards to age, sex, amount of contrast used, and procedure time. Partial thromboplastin time (PTT) and activated clotting time (ACT) were both significantly increased (P less than .01) in patients who received 10,000u heparin irrespective of type of contrast agent although larger increases were seen in the iohexol group. With 2000u of heparin, ACT and PTT increased significantly (P less than .01) only in the iohexol group. PTT and ACT actually decreased to similar and significant (P less than .01) degrees after both iohexol and ioxaglate when heparin was not used. We conclude: 1) commonly used measures of anticoagulant (ACT and PTT) show greater prolongation after either 2000 or 10,000u of heparin with iohexol than ioxaglate, 2) ACT and PCT appear to shorten with both iohexol and ioxaglate if no heparin is used. This data would suggest that ioxaglate does not have an anticoagulant advantage over iohexol.